Provider Demographics
NPI:1194796763
Name:DR. ROBERT H. SHARP, P.C.
Entity type:Organization
Organization Name:DR. ROBERT H. SHARP, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:712-623-6392
Mailing Address - Street 1:514 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:IA
Mailing Address - Zip Code:51566-2329
Mailing Address - Country:US
Mailing Address - Phone:712-623-9433
Mailing Address - Fax:712-623-6392
Practice Address - Street 1:514 4TH ST.
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:IA
Practice Address - Zip Code:51566
Practice Address - Country:US
Practice Address - Phone:712-623-9433
Practice Address - Fax:712-623-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-31
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0745471Medicaid
IA0252060004Medicare NSC
IA0745471Medicaid